PROFESSIONAL ISSUES

Pediatric society opposes independent practice of NPs

Nurse practitioners cry foul, but the American Academy of Pediatrics says patient safety is at the core of its revamped policy on scope of practice.

By Myrle Croasdale, AMNews staff. March 10, 2003.

It was a routine procedure resulting in an unexpected outcome.

The American Academy of Pediatrics dusted off its scope-of-practice policy for an update. Many meetings later, including some with nonphysician health care practitioners, the revamped policy was published in the February Pediatrics.

Then the phones lit up, the e-mails began circulating and the National Assn. of Pediatric Nurse Practitioners publicly criticized the AAP's policy and accused the group of unprofessional and deceptive behavior.

At the center of the brouhaha is a statement from the AAP scope-of-practice policy: "The AAP ... opposes the independent practice of nurse practitioners."

Carol Berkowitz, MD, lead author of the policy statement, explained, "For a nurse practitioner to open her own office and claim she can care for all types of pediatric problems, that's inappropriate."

The AAP said this is not a matter of wrangling over competition but one of maintaining quality of care. More nurse practitioners, physician assistants, psychologists, pharmacists, acupuncturists, naturopaths, chiropractors and other nonphysicians are delivering health care to children without the oversight of a pediatrician, putting the safety of children at risk, according to the AAP policy statement.

"We're advocating for children and quality of health care," Dr. Berkowitz said. "We'd be remiss to think that all self-proclaimed pediatric care providers can render the same care."

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